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BK virus-associated urothelial carcinoma-A supra-regional cohort of kidney transplant recipients.
СтатьяНазвание и аннотация: Перевод в очереди
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Beetge Noah, Ribeiro Luis, Zakri Rhana, Horsfield Catherine, Olsburgh Jonathon
Аннотация
OBJECTIVES: This study aims to study the clinical features, pathological findings, and outcomes of BK virus-associated urothelial carcinoma (UC) in kidney transplant recipients (KTRs).
PATIENTS AND METHODS: The study was conducted in a retrospective cohort of KTRs with histologically confirmed UC managed at a UK supra-regional transplant urology centre from November 2006 to January 2026. BK virus status was determined using polymerase chain reaction (PCR) testing, and tumour samples were assessed for SV40 large T antigen. Patients were stratified by BKV and SV40 status to enable comparison of tumour grade, stage, and other clinicopathological features.
RESULTS: 24 KTRs met the inclusion criteria; 11 of whom were BKV+. The mean follow-up time post-UC diagnosis was 7.3 ± 6.1 years. Mean age at UC diagnosis was 59.9 ± 14.6 years. 90.9% of BKV+ patients had high-risk UC compared to 30.8% of the BKV- group (p = 0.005). Tumour grade at diagnosis was higher in BKV+ patients (p = 0.013). SV40 Large T antigen was detected in 33.3% of cases, all with a previous history of BKV infection. These tumours were all high grade (G3) and had tended to be a higher stage at diagnosis than SV40- tumours (p = 0.050). UC in BKV+ patients was not diagnosed earlier post-transplant (p = 0.616). There was no difference in survival probability between the two cohorts (p = 0.639).
CONCLUSION: BKV infection in KTRs was associated with aggressive, high-grade UC. Screening and timely adjustment of immunosuppression are essential to protect this at-risk population. Further studies are required to clarify the oncogenic potential of BKV and optimise management strategies.
PATIENTS AND METHODS: The study was conducted in a retrospective cohort of KTRs with histologically confirmed UC managed at a UK supra-regional transplant urology centre from November 2006 to January 2026. BK virus status was determined using polymerase chain reaction (PCR) testing, and tumour samples were assessed for SV40 large T antigen. Patients were stratified by BKV and SV40 status to enable comparison of tumour grade, stage, and other clinicopathological features.
RESULTS: 24 KTRs met the inclusion criteria; 11 of whom were BKV+. The mean follow-up time post-UC diagnosis was 7.3 ± 6.1 years. Mean age at UC diagnosis was 59.9 ± 14.6 years. 90.9% of BKV+ patients had high-risk UC compared to 30.8% of the BKV- group (p = 0.005). Tumour grade at diagnosis was higher in BKV+ patients (p = 0.013). SV40 Large T antigen was detected in 33.3% of cases, all with a previous history of BKV infection. These tumours were all high grade (G3) and had tended to be a higher stage at diagnosis than SV40- tumours (p = 0.050). UC in BKV+ patients was not diagnosed earlier post-transplant (p = 0.616). There was no difference in survival probability between the two cohorts (p = 0.639).
CONCLUSION: BKV infection in KTRs was associated with aggressive, high-grade UC. Screening and timely adjustment of immunosuppression are essential to protect this at-risk population. Further studies are required to clarify the oncogenic potential of BKV and optimise management strategies.